• Radiation Oncology Journal
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• v.27 no.1
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• pp.1-9
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• 2009

There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.69-87
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• 1989

It is well known that the glucocorticoid induces osteoporosis by suppression of the osteoblast, but its effect on the osteoclast hRS some controversy whether it activates or suppresses the osteoclast. If the calcitonin, which is known to suppress the osteoclast, prevents the osteoporosis by glucocorticoid, then the suppression of the osteoclast by the glucocorticoid is not so significant. And if the calcitonin increases the osteoblastic activity, Tc-99m MDP uptake will be increased in spite of the glucocorticoid effect on the osteoblast. The immobilization operation was performed to the right leg of male Wistar rats weighing about 200gm. each. For 16 weeks after operation, rats were injected glucocorticoid alone or glucocorticoid anci calcitonin. The bone density was measured by means of photodensitometry under reference aluminum step wedge and Tc-99m MDP uptake was available to the index of the osteoblastic activity. 1. The bone density of femora! head was markedly reduced than that of femoral shaft following ration of cancellous and cortical components in both site. 2. Glucocorticoid caused decrease in bone density of spine and femur, md there is significantly increase of it when medication of glucocorticoid and calcitonin injection simultaneously than that of glucocorticoid. 3. Tc-99m MDP uptake was revealed significant reduction in medication of glucocorticoid but increase in gi;.:cocorticoid and calcitonin injection simultaneously in later experimental period. 4. There wail, a slight reduction in plasma osteocalcin in medication of glucocorticoid through experimental periods and an increase in its value in case of giving glucocorticoid and calcitonin simultaneously in later experimental period. From these results, we suggest that osteoporosis by immobilization is more pronounced by glucocorticoid hormone and osteoporosis induced by immobilization and glucocorticoid use is prevented by calcitonin administration with increasing osteoblastic activity.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.263-274
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• 1998

One of the main purposes in the treatment of developmental dislocation of the hip is to achieve and maintain concentric, congruent, and stable reduction. The arthrogram performs an important role in the diagnosis and treatment of developmental dislocation of the hip. The arthrogram provides much information about the soft tissue status of the hip joint. Limbus and ligamentum teres is exactly evaluated so that we can plan the reduction and treatment before operation. Eighteen preoperative hip arthrograms of 17 children treated for developmental dislocation of the hip from 1992 to 1998 were reviewed. The limbus, ligamentum teres and transverse acetabular ligament were compared with the pathoanatomy seen at the time of open reduction. Arthrography proved to be reliable in identifying the limbus and ligamentum teres. So we recommend that arthrography must be performed before closed or open reduction. Also, we recorded the radiographic parameters: acetabular index, acetabular floor thickness, center edge(CE) angle of Wiberg, and Y-coordinate. The center edge(CE) angle of Wiberg obtained from arthrography was measured more accurately than from simple roentgenograms because the ossification of the femoral head was frequently located eccentrically in the developmental dislocation of the hip.

• The Korean Journal of Nuclear Medicine
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• v.19 no.1
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• pp.73-75
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• 1985

Acute transient synovitis of the hip presents clinically pain and limping. But in the majority of the cases, definite positive findings are not manifest in roentgenogram in its early phase. However radionuclide bone imaging combines with the assessment of vascularization and bone tracer uptake is of great value in solving this diagnostic problem. The materials for this study consisted of 29 children with acute transient synovitis of the hip, characterized by symptoms and physical signs of an arthritis, negative X-ray findings and disappearance of all symptoms and signs within a short period of time. They were twenty males and 9 females and age ranged from 1 to 12 years. We took pelvic reontgenogram in AP and frog-leg views. After intravenous bolus injection of 10 to 15 mCi of $^{99m}Tc-methylene$ diphosphonate, 24 sequential image of the pelvis was taken at 2-second interval for blood flow study. The scintigrams were made using a gamma camera with high resolution parallel hole collimator. Blood pool imaging was obtained at 2 minutes after tracer administration. After 3 hours, static images were taken and then closeup image of the hip using pin-hole collimator was followed. The results were as follows: 1) Bone scintigram was much more sensitive than conventional roentgenogram in diagnosis of acute transient synovitis of the hip. 2) Three-phase imagings showed increased vascular activities in blood pool scintigrams in 96%. 3) Pin-hole imaging showed increased tracer uptake in the regional bones of the hip, par ticularly in the medial aspect of femoral head and acetabulum. 4) We confirmed that three-phase imaging reinforced with pin-hole technique were very useful in diagnose of acute transient synovitis of the hip.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.55-58
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• 2012

We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had $4{\times}3cm$ and $6{\times}5cm$ scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.103-106
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• 2018

Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.185-189
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• 2007

Advancement of imaging and surgical technique makes the internal hemipelvectomy one of the routine procedures of pelvis sarcoma. However, optimal reconstructive option for skeletal defect is still controversial. Pasteurized autogenous bone-total hip composite is a biologic method and its anatomical appropriateness gives good indication for selected cases. Nevertheless, in case of complication such as infection or mechanical breakage, removal of hardware including graft is inevitable. In those cases, marked limb length discrepancy induce marked functional deficit. To overcome this problem, the authors report 1 case, refining previous technique, saving the femoral head and reinsertion of osteoarticularly pasteurized host bone.

• Journal of the Korea Computer Graphics Society
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• v.25 no.3
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• pp.123-131
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• 2019

In this study, we modified CT images of femoral head in consideration of anatomically meaningful structure, proposing the method to augment the training data of convolution Neural network for segmentation of femur mesh model. First, the femur mesh model is obtained from the CT image. Then divide the mesh model into meaningful parts by using cluster analysis on geometric characteristic of mesh surface. Finally, transform the segments by using an appropriate mesh deformation algorithm, then create new CT images by warping CT images accordingly. Deep learning models using the data enhancement methods of this study show better image division performance compared to data augmentation methods which have been commonly used, such as geometric conversion or color conversion.

• Progress in Medical Physics
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• v.29 no.4
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• pp.157-163
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• 2018

Plans converted using dose-volume-histogram-based plan conversion (DPC) were evaluated by comparing them to the original plans. Changes in the dose volumetric (DV) parameters of five volumetric modulated arc therapy (VMAT) plans for head and neck (HN) cancer and five VMAT plans for prostate cancer were analyzed. For the HN plans, the homogeneity indices (HIs) of the three planning target volumes (PTV) increased by 0.03, 0.02, and 0.03, respectively, after DPC. The maximum doses to the PTVs increased by 1.20, 1.87, and 0.92 Gy, respectively, after DPC. The maximum doses to the optic chiasm, optic nerves, spinal cord, brain stem, lenses, and parotid glands increased after DPC by approximately 4.39, 3.62, 7.55, 7.96, 1.77, and 6.40 Gy, respectively. For the prostate plans after DPC, the HIs for the primary and boost PTVs increased by 0.05 and 0.03, respectively, and the maximum doses to each PTV increased by 1.84 and 0.19 Gy, respectively. After DPC, the mean doses to the rectum and femoral heads increased by approximately 6.19 and 2.79 Gy, respectively, and those to the bladder decreased by 0.20 Gy when summing the primary and boost plans. Because clinically unacceptable changes were sometimes observed after DPC, plans converted by DPC should be carefully reviewed before actual patient treatment.

• Journal of the Institute of Convergence Signal Processing
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• v.21 no.4
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• pp.183-194
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• 2020

Recently, the number of hip dysplasia (DDH) that occurs during infant and child growth has been increasing. DDH should be detected and treated as early as possible because it hinders infant growth and causes many other side effects In this study, two modelling techniques were used for multiple training techniques. Based on the results after the first transformation, the training was designed to be possible even with a small amount of data. The vertical flip, rotation, width and height shift functions were used to improve the efficiency of the model. Adam optimization was applied for parameter learning with the learning parameter initially set at 2.0 x 10e-4. Training was stopped when the validation loss was at the minimum. respectively A novel image overlay system using 3D laser scanner and a non-rigid registration method is implemented and its accuracy is evaluated. By using the proposed system, we successfully related the preoperative images with an open organ in the operating room